What Causes Mesenteric Panniculitis & How Is It Treated?

What is Mesenteric Panniculitis?

Mesenteric Panniculitis is an extremely rare and benign fibrotic inflammatory condition that adversely affects the fat tissues of the mesentery in the colon and the small intestine. Anatomically speaking, the mesentery is a collection of tissue folds in the abdominal region that functions by keeping the abdominal wall in its normal anatomical space by connecting it to the intestine. What exactly causes Mesenteric Panniculitis is something which is not yet clear and research is still ongoing with regard to this. A diagnosis of this condition however can be confirmed through CT scan and biopsies [2].

What is Mesenteric Panniculitis?

A definite treatment for Mesenteric Panniculitis is usually surgery; however, there are medications available which can effectively manage the symptoms of Mesenteric Panniculitis. The surgical approach for treatment of this condition is however is quite limited. The inflammation caused by Mesenteric Panniculitis destroys the fat cells present in the mesentery and often leads to development of scar tissues along with other associated symptoms that require further treatment [1].

Mesenteric Panniculitis has three stages which include:

Mesenteric Lipodystrophy: This condition occurs when the fat cells present in the mesentery are replaced by immune cells.

Mesenteric Panniculitis: This occurs when the immune cells that replace the fat cells in the mesentery cause inflammation.

Retractile Mesenteritis: This condition occurs when there is gradual worsening of the inflammation caused by the immune and there is development of scar tissues within the mesentery [2].

In general, Mesenteric Panniculitis is a benign condition and poses no threat to the overall health condition of the affected individual. However, the symptoms caused by the condition can impact the quality of life of the patient. Moreover it may signify the presence of a more serious underlying medical condition requiring diagnosis and treatment. This article highlights some of the causes of Mesenteric Panniculitis and different ways to manage the condition [1, 2].

What Causes Mesenteric Panniculitis?

As of now, the exact cause of Mesenteric Panniculitis is not yet known and treatment is rendered as it is done for some other autoimmune disorder. An individual is said to have an autoimmune condition when the immune cells of the body starts attacking the healthy tissues of the body taking them as invaders. This leads to various symptoms. In case of Mesenteric Panniculitis, the immune system attacks the cells and tissues of the mesentery causing inflammation and scar tissue formation [2].

Some researchers believe that there is a genetic link to the development of Mesenteric Panniculitis in that there have been some cases where the affected individual has a direct relative who also has had this disorder or some other autoimmune condition. It is also observed that Mesenteric Panniculitis occurs mostly in people above the age of 65 years and its prevalence is more in males than females. Additionally, certain infections, trauma, or complications of surgery around the abdominal region may also cause inflammation of in the mesentery resulting in Mesenteric Panniculitis [2].

There are also certain forms of cancer which causes inflammation in the mesentery resulting in Mesenteric Panniculitis. These forms of cancer include prostate cancer, cancer of the kidneys, colon cancer, and lung cancer to name a few. There are also certain medical conditions that cause inflammation of the mesentery. These medications include retroperitoneal fibrosis and sclerosing cholangitis [2].

How is Mesenteric Panniculitis Treated?

Coming to the treatment options for Mesenteric Panniculitis, management is aimed at controlling the symptoms and improving the quality of life of the patient. In mild cases of Mesenteric Panniculitis, generally there is no treatment required and there is spontaneous resolution of the symptoms even though it may take more than month for this to happen. In severe forms of Mesenteric Panniculitis, the patient will most likely require frequent followups for symptom monitoring [2].

Medications that are given to patients with Mesenteric Panniculitis usually control the inflammation and allow the patient to carry out basic activities of daily living without any discomfort. Corticosteroids are the medications of choice for calming down inflammation in the mesentery. If any underlying medical condition is responsible for causing this condition then treatment of that condition will be required to control the symptoms of Mesenteric Panniculitis [2].

These medications may include drugs for suppressing the growth of a tumor or suppress the immune system. Even though Mesenteric Panniculitis in majority of the cases is harmless there are a few instances where complications have occurred. In cases where the inflammation is profound then it can lead to blockage of the intestines. This may result in worsening of symptoms like nausea and vomiting and excruciating abdominal pain [2].

Additionally, the intestines will not be able to absorb nutrients from the food as a result of the blockage. It is important for physicians to exclude cancers in a patient with Mesenteric Panniculitis since cancer is something which is commonly seen in people with this condition [2].

In conclusion, Mesenteric Panniculitis is a harmless autoimmune disorder which occurs when the immune cells replace the fat cells in the mesentery and destroy them. The mesentery is a fold of tissue that connects to the intestine and works by keeping the abdominal wall in its normal space. The overactive immune system causes inflammation of the mesentery resulting in a variety of symptoms [1, 2].

While Mesenteric Panniculitis is a benign condition, it may significantly dent the quality of life of the patient where he or she will find it tough to even do daily activities. The exact cause of this condition is not yet known but some researchers believe it to have a genetic link. Certain forms of cancers also cause inflammation in the mesentery resulting in Mesenteric Panniculitis. Additionally, trauma or a complication of a surgical procedure around the abdominal region also tends to cause inflammation in the mesentery [1, 2].

Severe cases of inflammation result in the formation of scar tissue. Mild cases of Mesenteric Panniculitis do not require any treatment and the symptoms fade away on their own in a span of a few months. Severe cases of inflammation and scar tissue formation requires medical treatment and diligent followups on the part of the patient.

Corticosteroids and other immune suppressants are often prescribed for treating the inflammation and allowing the patient to carry out basic activities of daily living [2].

It is also essential for physicians to check for any potentially serious underlying medical condition that could be causing inflammation in the mesentery like cancer or retroperitoneal fibrosis. It is also important for an individual with Mesenteric Panniculitis to diligently follow the advice of the treating physician to check on the status of the inflammation to prevent any unwarranted complications that may arise due to Mesenteric Panniculitis [2].

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